scholarly journals The Questionable Value of Having a Choice of Levels of Health Insurance Coverage

2017 ◽  
Vol 31 (4) ◽  
pp. 51-72 ◽  
Author(s):  
Keith Marzilli Ericson ◽  
Justin Sydnor
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Insurance Markets ◽  
Individual Level ◽  
Health Insurance Markets ◽  
Consumer Confusion ◽  
Multiple Levels

In most health insurance markets in the United States, consumers have substantial choice about their health insurance plan. However additional choice is not an unmixed blessing as it creates challenges related to both consumer confusion and adverse selection. There is mounting evidence that many people have difficulty understanding the value of insurance coverage, like evaluating the relative benefits of lower premiums versus lower deductibles. Also, in most US health insurance markets, people cannot be charged different prices for insurance based on their individual level of health risk. This creates the potential for well-known problems of adverse selection because people will often base the level of health insurance coverage they choose partly on their health status. In this essay, we examine how the forces of consumer confusion and adverse selection interact with each other and with market institutions to affect how valuable it is to have multiple levels of health insurance coverage available in the market.

scholarly journals Young Adult's Perspectives on Being Uninsured and Implications for Health Reform

2014 ◽  
Author(s):  
Kim Dauner ◽  
Jack Thompson
Keyword(s):  
Young Adults ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
State Health ◽  
Individual Level ◽  
State Health Insurance ◽  
Federal Statute ◽  
Insurance Exchanges

Young adults between the ages of 18-34 are most likely to lack health insurance in the United States. The Affordable Care Act (ACA), a federal statute signed into law in 2010, contains provisions specific to increasing access to health insurance for young adults including the provision that persons under 26 can stay on their parents’ insurance. While the reasons for uninsurance among young adults have been documented, how they operate and are perceived on an individual level have not been explored in great detail. Further, it is poorly understood how the ACA policies and the state health insurance exchanges can serve young adults. Thus, we interviewed uninsured young adults aged 18-35 in northeastern Minnesota and northwestern Wisconsin and used inductive thematic analysis to explore these issues. Findings suggest that young adults don’t feel at risk for health problems and therefore have low levels of health insurance literacy and place little value on health insurance. Multiple barriers to health insurance coverage, including the provision about staying on a parent’s policy, persist despite the ACA. Our findings also suggest valuable lessons for state health insurance exchanges on how to better serve this population.

scholarly journals After Midnight: A Regression Discontinuity Design in Length of Postpartum Hospital Stays

2011 ◽  
Vol 3 (3) ◽  
pp. 1-34 ◽  
Author(s):  
Douglas Almond ◽  
Joseph J Doyle
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Length Of Hospital Stay ◽  
Health Insurance Coverage ◽  
Insurance Markets ◽  
Regression Discontinuity Design ◽  
Insurance Mandates ◽  
Health Insurance Markets ◽  
Hospital Stays ◽  
Exogenous Source

Estimates of moral hazard in health insurance markets can be confounded by adverse selection. This paper considers a plausibly exogenous source of variation in insurance coverage for childbirth in California. We find that additional health insurance coverage induces substantial extensions in length of hospital stay for mother and newborn. However, remaining in the hospital longer has no effect on readmissions or mortality, and the estimates are precise. Our results suggest that for uncomplicated births, minimum insurance mandates incur substantial costs without detectable health benefits. (JEL D82, G22, I12, I18, J13)

scholarly journals Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts

2013 ◽  
Vol 103 (7) ◽  
pp. 2643-2682 ◽  
Author(s):  
Benjamin R Handel
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Large Firm ◽  
Choice Model ◽  
Major Change ◽  
Insurance Markets ◽  
Individual Level ◽  
Health Insurance Markets ◽  
Ex Ante ◽  
The Impact

This paper investigates consumer inertia in health insurance markets, where adverse selection is a potential concern. We leverage a major change to insurance provision that occurred at a large firm to identify substantial inertia, and develop and estimate a choice model that also quantifies risk preferences and ex ante health risk. We use these estimates to study the impact of policies that nudge consumers toward better decisions by reducing inertia. When aggregated, these improved individual-level choices substantially exacerbate adverse selection in our setting, leading to an overall reduction in welfare that doubles the existing welfare loss from adverse selection. (JEL D82, G22, I13)

scholarly journals The COVID-19 Pandemic and Health Insurance Regulation

2021 ◽  
Vol 40 ◽  
Author(s):  
Joshua D. Frederick ◽  
J. Bradley Karl
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
State Level ◽  
Health Insurance Coverage ◽  
Policy Implications ◽  
Insurance Markets ◽  
Insurance Regulation ◽  
Health Insurance Markets ◽  
Catastrophic Risks ◽  
Insight Into

With projections of costs in the billions for COVID-19 treatments alone, and heightened scrutiny on COVID-19-related health insurance coverage, the National Association of Insurance Commissioners (NAIC) convened in March 2020 to discuss how the industry could best deal with a pandemic. While the ramifications of the COVID-19 event are in their infant stages, it is important to consider the implications such catastrophic risks have on an insurance market. We evaluate state-level changes presented by the NAIC in response to the COVID-19 pandemic and use prior research to offer insight into health insurance in a post-COVID-19 world. This manuscript aims to provide a summary of the NAIC’s current standing during the pandemic, while presenting insight into policy implications regarding regulation in health insurance markets during catastrophic events.

Data Processing Improvements for Estimates of Health Insurance Coverage in the Current Population Survey Annual Social and Economic Supplement

2021 ◽  
pp. 107755872110008
Author(s):  
Edward R. Berchick ◽  
Heide Jackson
Keyword(s):  
Health Insurance ◽  
Data Processing ◽  
Current Population Survey ◽  
Population Survey ◽  
Insurance Coverage ◽  
Processing System ◽  
Health Insurance Coverage ◽  
The United States ◽  
Health Insurance Data ◽  
Current Population

Estimates of health insurance coverage in the United States rely on household-based surveys, and these surveys seek to improve data quality amid a changing health insurance landscape. We examine postcollection processing improvements to health insurance data in the Current Population Survey Annual Social and Economic Supplement (CPS ASEC), one of the leading sources of coverage estimates. The implementation of updated data extraction and imputation procedures in the CPS ASEC marks the second stage of a two-stage improvement and the beginning of a new time series for health insurance estimates. To evaluate these changes, we compared estimates from two files that introduce the updated processing system with two files that use the legacy system. We find that updates resulted in higher rates of health insurance coverage and lower rates of dual coverage, among other differences. These results indicate that the updated data processing improves coverage estimates and addresses previously noted limitations of the CPS ASEC.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

The Impact of the Affordable Care Act Medicaid Expansions on the Sources of Health Insurance Coverage of Undergraduate Students in the United States

2021 ◽  
pp. 107755872110158
Author(s):  
Priyanka Anand ◽  
Dora Gicheva
Keyword(s):  
United States ◽  
Health Insurance ◽  
Undergraduate Students ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Medicaid Expansions

This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions—that is, some students substituted their private and employer-sponsored coverage for Medicaid.

scholarly journals Union Effects on Health Insurance Provision and Coverage in the United States

ILR Review ◽  
2002 ◽  
Vol 55 (4) ◽  
pp. 610-627 ◽  
Author(s):  
Thomas C. Buchmueller ◽  
John Dinardo ◽  
Robert G. Valletta
Keyword(s):  
United States ◽  
Health Insurance ◽  
Survey Data ◽  
Insurance Coverage ◽  
Health Benefits ◽  
Union Density ◽  
Health Insurance Coverage ◽  
The United States ◽  
Health Coverage ◽  
Private Sector Union

During the past two decades, union density has declined in the United States and employer provision of health benefits has changed substantially in extent and form. Using individual survey data spanning the years 1983–97 combined with employer survey data for 1993, the authors update and extend previous analyses of private-sector union effects on employer-provided health benefits. They find that the union effect on health insurance coverage rates has fallen somewhat but remains large, due to an increase over time in the union effect on employee “take-up” of offered insurance, and that declining unionization explains 20–35% of the decline in employee health coverage. The increasing union take-up effect is linked to union effects on employees' direct costs for health insurance and the availability of retiree coverage.

scholarly journals Health Insurance Coverage and Adverse Selection

2011 ◽  
pp. 225-231 ◽  
Author(s):  
Philippe Lambert ◽  
Sergio Perelman ◽  
Pierre Pestieau ◽  
Jérôme Schoenmaeckers
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Insurance Coverage ◽  
Health Insurance Coverage
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